Grant Number:	3P01CA250989-03S1 Interpret this number
Primary Investigator:	Brewer, Noel
Organization:	Univ Of North Carolina Chapel Hill
Project Title:	Program Project – Improving Provider Announcement Communication Training (IMPACT)
Fiscal Year:	2023

PROJECT SUMMARY/ABSTRACT This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 23-044. Human papillomavirus (HPV) infections cause nearly 35,000 cervical, anal, oropharyngeal, and other cancers a year in the United States. Up-to-date (UTD) HPV vaccination (i.e. 2 doses by age 13) is only 49% as of 2021, far behind the >85% coverage of tetanus-diphtheria-acellular pertussis and meningococcal conjugate vaccines also recommended at this age. A provider’s clear recommendation for HPV vaccination has a large effect on uptake, and recommending HPV vaccination at ages 9-10 is associated with higher rates of UTD HPV vaccination. To support more effective monitoring by state vaccination programs, the Centers for Disease Control and Prevention (CDC) is supporting expanded use of immunization information systems (IIS). Jurisdictions can integrate clinical decision support into IIS based on state and local priorities, forecasting when recommended vaccines are due and disseminating these recommendations consistently statewide. Data are needed on a) how IIS are configured and which factors influence state- specific IIS design and functionality; b) whether state IIS trigger age-based HPV vaccination alerts to guide provider recommendations; and c) how the age of HPV vaccination alerts is decided. Characterizing state IIS features will provide preliminary data for future studies to evaluate their impacts on provider recommendations for HPV vaccination and rates of UTD HPV vaccination. This proposed supplement to the “Improving Provider Announcement Communication Training” project (1P01CA250989-01A1, PI: Brewer) will evaluate the impact of state IIS policies and priorities on HPV vaccination rates with three activities: 1) Gather and document data from the published literature, immunization program webpages for the 64 US states and jurisdictions receiving funding, and immunization program personnel; 2) Identify up to 15 IIS policy stakeholders in three states with contrasting HPV vaccination forecasting; and 3) Disseminate case summaries to guide IIS priority-setting and implementation across jurisdictions. This supplement will advance the goals of the parent P01 Program Project by optimizing important precursors to clinical staff's HPV vaccination recommendation: rapid and convenient ascertainment of a patient's HPV vaccination status, and ability to identify vaccine-eligible patients at the earliest opportunity. The project activities will provide data to support future empirical analyses of associations between state IIS policies and optimal cancer prevention, with potential to harmonize national HPV vaccination recommendations and update national HPV vaccination policies.





None. See parent grant details.